Wellbutrin and Lexapro

[Breastfriend]

I realize this question comes up quite frequently: Breastfeeding with Wellbutrin 150 mg per day and Lexapro 20 mg per day.
Mom has been taking these medications throughout her pregnancy. My assumption is that it is Ok to breastfeed given we have an L3 and L2 med. Baby is full term and almost 9 lbs. Mom has cardiac hx but doing well.
Neonatologist is quite concerned about breastfeeding with these meds and wants to tell the new mom she cannot breastfeed due to risk of infant seizures. Your recommendations please. Have printed the Med info sheets and given to mom and MD.

Thank you

[Sandra]

Breastfriend,

This baby probably received far more in utero then what they will receive through the breast milk. Only 0.11-1.99% of Wellbutrin and 5.2-7.9% of the Lexapro transfers through breast milk. There has been 2 case reports of seizures reported. The first case they could not rule out a febrile seizure and and with the second case the mom was on Lexapro and added Wellbutrin and about a week later the baby started having seizure activity so we cannot rule out the possibility of seizures, but many mothers breastfeed without complications. We think it is probably ok as long as the baby is not symptomatic. Monitor the infant for sedation or irritability, poor feedings, poor weight gain and seizures.

Sandra Lovato R.N.
InfantRisk Center